Which surgical operation requires division of the lesser omentum to access lymph nodes?

The surgical operation that requires division of the lesser omentum to gain access to lymph nodes is radical gastrectomy. During this procedure, the lesser omentum is typically divided to allow the surgeon access to the stomach and surrounding structures, including lymphatic drainage routes.

This is particularly relevant in cases of gastric cancer, where removal of involved lymph nodes is crucial for staging and treatment. The lesser omentum, which extends from the liver to the lesser curvature of the stomach, contains important blood vessels (such as the right gastric and gastroepiploic arteries) and lymphatic channels, making it necessary to navigate and divide this structure to access lymph nodes involved in the cancer's spread.

In contrast, other procedures listed do not necessitate this specific action. For example, appendectomy is performed on the cecum and involves no manipulation of the lesser omentum, while cholecystectomy focuses on the gallbladder and hernia repair usually involves working with the abdominal wall muscle and soft tissue, without any requirement to access the lesser omentum or its associated structures.